The California Department of Public Health’s (DPH) Antipsychotic Drug Collaborative has issued its first citation and monetary fine against a nursing home for illegally drugging residents with chemical restraints. The citation was issued against Briarwood Health Care – a nursing home in Sacramento – and carried a $1,000 fine.
CANHR recently published a report about the Collaborative’s findings. In short, DPH investigated 24 nursing homes for possible misuse of antipsychotic drugs and found 147 violations of state rules. CANHR was critical of the Collaborative’s enforcement efforts, partially because it ignored federal law in the investigations and because no fines were issued to any of the flagged nursing homes. The citation against Briarwood is a first on both accounts.
At Briarwood, three residents were receiving “unnecessary” antipsychotics. In one case, a resident with a perfect mini-mental status exam score and no evidence of cognitive deficits or problematic behaviors was drugged with antipsychotics Seroquel and Abilify for nearly six months. The resident believed she was getting a “sleeping pill.” At one point, the facility’s consultant pharmacist pointed out the myriad risks of double antipsychotics to the resident’s doctor but the doctor ordered the medications be continued without noting any reason. For this, the facility was fined a total of $1,000.
Illegal drugging of nursing home residents, especially when much safer and caring alternatives exist, is manifest elder abuse and it’s long past time for DPH to treat it as such. The Briarwood drugging cases are just a sliver of the continued chemical restraint epidemic that is on-going in many California nursing homes. We are glad to see DPH finally take some real enforcement action but a $1,000 fine for six months of wrongful drugging with antipsychotics hardly seems satisfactory. If the Collaborative is serious about improving the quality of life of nursing home residents, many more citations – coupled with meaningful fines – will be forthcoming.